ASSESSMENT | RANGE | IMPLICATIONS |
Serum Magnesium Levels | 4-7 mEq/L (5-8mg/dl) 8-10 mEq/L (9-12mg/dl) 10-12 mEq/L (12-15mg/dl) 12-15 mEq/L (15-18mg/dl) 15-20 mEq (18-25mg/dl) 20-25 mEq (25-30 mg/dl) | Therapeutic range Loss of both tendon reflexes Respiratory depression Respiratory arrest Bradycardia, arrhythmia, heart block Cardiac arrest |
Deep Tendon Reflexes (DTR) | Reflex Absent 0 Less than Normal or +1 diminished Low Normal +2 High Normal +3 Brisk with Clonus +4 | Reflexes should be checked hourly. DTR are a good indicator of Magnesium Toxicity. The goal of Magnesium Therapy is for DTR to be increased but not absent a sudden change in DTR or absence of reflexes warrants _____________ of the medicalon. |
Respiration | 12-20 breaths/min | Below 12 bpm medication is discontinued and the physician is notified |
Pulse | 60-100 bpm | Drop of pulse – report to physician and discontinued of below 60 |
Blood Pressure | 100-140 mmHg systolic 60-90 mmHg diastolic | BP needs to be maintained at a systolic level of 100 mmHg for placental perfusion. The accuracy of the measurement is essential, the arm should be at the heart level and an appropriately sized cuff used-inform physician |
Fetal Heart Rate | 120-160 beats/min | Decreased signs of fetal distress are reported to the physician |
Urine Output | At least 30 cc per hour | Fcatheter is inserted to be accurate magnesium is exerted through the kidneys, woman with hypertensive disorders of pregnancy may have decrease kidney functioning that can contribute to magnesium toxicity. If the urine output is assessed for hyporeflexia more frequently. |
Side effects | Facial flushing, hot flushes nausea, vomiting, headaches muscle weakness, drowsiness | These symptoms are more pronounce with the rapid infusion of loading doses. Explanation to patient and family are essential. Mark lethargy or decrease level of consciousness is reported to physician |
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